ORTHODONTIC SPECIALISTS OF MINNESOTA, P.L.L.C. (NPI# 1306338553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306338553 |
| Entity Type | Organization |
| Organization Name | ORTHODONTIC SPECIALISTS OF MINNESOTA, P.L.L.C. |
| Other Organization Name | THE DENTAL SPECIALISTS-ORTHODONTICS |
| Practice Address |
1109 Moore Lake Dr E Fridley MN 55432 |
| Mailing Address |
2200 County Road C W Ste 2210 Roseville MN 55113-2551 |
| Practice Telephone | 7635722224 |
| Mailing Telephone | 6517462815 |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DR. JOHN GULON (PRESIDENT) |
| Authorized Official Telephone | 6517462815 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| The Dental Specialists-Orthodontics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588156525 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 18315 Cascade Dr Ste 110, Eden Prairie, MN 55347 | 2018-06-05 |
| 1629560677 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 9325 Upland Ln N Ste 330, Maple Grove, MN 55369-4462 | 2018-06-05 |
| 1548818560 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 675 E Nicollet Blvd Ste 120, Burnsville, MN 55337-6748 | 2019-09-03 |
| 1295227247 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2018-06-05 |
| 1245722297 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 40 W Nicollet Blvd, Burnsville, MN 55337-4524 | 2018-06-05 |
| 1902398944 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 12904 Central Ave Ne, Blaine, MN 55434 | 2018-06-05 |
| 1699267633 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 1150 Hazeltine Blvd, Chaska, MN 55318 | 2018-06-05 |
| 1053685586 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 2200 County Road C W, Suite 2210, Roseville, MN 55113 | 2012-03-01 |
| 1821362302 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 6545 France Ave S, Suite 381, Edina, MN 55435 | 2012-03-01 |
| Street Address |
1109 MOORE LAKE DR E |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407166317 | Northern Orthodontics | Clinic/Center | 1109 Moore Lake Dr E, Fridley, MN 55432-5171 | 2010-10-13 |
| 1679904189 | Straight Smiles, Pllc | Clinic/Center | 1109 Moore Lake Dr E, Fridley, MN 55432-5171 | 2013-12-09 |
| 1003245333 | Dental Specialists of Minnesota, Pllc | Dentist | 1109 Moore Lake Dr E, Fridley, MN 55432-5171 | 2013-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100974 | Candid Minnesota, Pllc | Dentist | 15 S 9th St Ste 97, Minneapolis, MN 55402-3105 | 2020-09-23 |
| 1518572916 | Smile Orthodontics Stillwater LLC | Dentist | 2008 Ford Pkwy, Saint Paul, MN 55116-1931 | 2020-09-11 |
| 1508476482 | Sensational Smiles | Dentist | 950 Nicollet Mall Ste 220, Minneapolis, MN 55403-2534 | 2020-08-05 |
| 1457969636 | Eden Prairie Orthodontic Assoc | Dentist | 8200 Commonwealth Dr # 100, Eden Prairie, MN 55344-5365 | 2020-07-14 |
| 1164040457 | Colby Orthodontics LLC | Dentist | 9th St. and Nicollet Ave. Suite 531, Minneapolis, MN 55402 | 2020-07-13 |
| 1619595220 | Tracy Miao Liang | Dentist | 515 Delaware St Se # 320, Minneapolis, MN 55455-0357 | 2020-07-09 |
| 1477170108 | Jesse N Veil Dds Ms Pa | Dentist | 250 Fuller St S Ste 100, Shakopee, MN 55379-1324 | 2020-06-29 |
| 1124663067 | Bruce William Anderson | Dentist | 2725 Fox Farm Rd, Worthington, MN 56187-3040 | 2019-11-14 |
| 1598300675 | Dentalign, Pa | Dentist | 11942 Business Park Blvd, Champlin, MN 55316 | 2019-11-12 |
| 1528622883 | Margaret Therese Anderson | Dentist | 2019 Jefferson Rd Ste C, Northfield, MN 55057-3258 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.